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SA infant's death was preventable: coroner

Margaret Scheikowski

The death of an infant in outback South Australia could have been prevented if a GP had admitted her to hospital instead of sending her home, a coroner has found.

In delivering his findings on Thursday, Deputy State Coroner Anthony Schapel called for the promulgation of guidelines for rural and remote medical practitioners examining youngsters who have gastroenteritis.

Other recommendations included that such practitioners should familiarise themselves with local conditions, such as distances from medical care, to help when deciding whether those youngsters should be admitted to hospital or sent home.

Olivia Jean Johnson, aged 11 months, died from dehydration in May 2011 at her family's home at the remote Balcanoona Station, a two hour road trip to Leigh Creek in the state's north.

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"I find that Olivia's death was preventable," the coroner said.

Hours before her death, her parents, Melissa Hands and Wade Johnson, drove along the mainly dirt road to the Leigh Creek Hospital and Medical Clinic after she suffered bouts of vomiting and diarrhoea.

Ms Hands, who had packed a bag in case they were sent on to Port Augusta for treatment, specifically raised with Dr Geoffrey Cox the possibility that Olivia was dehydrated.

But the GP believed she had gastro and did not have any signs of dehydration.

Dr Cox told Ms Hands to keep Olivia's fluids up, to buy a rehydrating agent for her and to bring her back if the diarrhoea persisted.

The coroner found Dr Cox's recording of Olivia's medical history was inadequate, particularly in relation to the number of times she had experienced diarrhoea.

The GP had an inadequate appreciation of the quantity of fluid Olivia had lost and should have accepted the mother's assertions that Olivia's eyes appeared abnormal - a sign of dehydration.

Further, inadequate consideration was given to the fact that Olivia's home was as much as a two hour drive away from Leigh Creek.

This meant it was "effectively out of reach of urgent medical assistance should Olivia have required it".

The coroner acknowledged that, as a locum practitioner, Dr Cox was confined to the town for his working period and only had a limited opportunity to familiarise himself with local conditions.

Further, Olivia's hypernatraemic dehydration was an uncommon condition and he might have been misled by its atypical symptoms.